Doctoring the data.(the Health Care Economist)

The national debate over health care is so polarized that many people don't seem to care about the facts any more. An article in the prestigious journal Health Affairs comparing the quality of health care in the U.S. and four other countries--the United Kingdom, New Zealand, Australia, and Canada--purports to show that the U.S. spends far more per capita without getting better results. Major newspapers parroted the claim: "U.S. Patients Spend More But Don't Get More, Study Finds," read a Washington Post headline. "U.S. Isn't No. 1" the Christian Science Monitor announced.

The danger is that this study ("How Does the Quality of Care Compare in Five Countries?") will be flaunted by advocates of government-run, single-payer health care. One of the study's authors, Professor Arnold Epstein of the Harvard School of Public Health, told reporters the findings should make Americans reconsider their allegiance to private health care. Not so fast.

The study claims that the U.S. ranks lowest in survival rates for kidney and liver transplant recipients. Low survival rates mean transplant patients in the U.S. received lower quality care, "assuming that transplant recipients in the five countries are similar" the authors glibly write. That assumption is dead wrong. Transplant recipients are not similar. The U.S. alone among the countries surveyed routinely offers transplants to patients over age 65 and re-transplants if the first one fails.

Astoundingly, the study fails to examine the treatment of heart disease, the most costly health problem in the United States. How can the authors claim to prove that higher U.S. spending on health care doesn't produce better results if their study doesn't even examine where the largest single portion of the money goes?

In the U.S., treating a heart attack costs at least $10,000 more (in real dollars) than it did in 1984, but heart patients now live longer and have fewer restrictions on their activities than they did in earlier decades. Higher costs are producing longer and better lives.

In the U.K., costs have been kept down by delaying the adoption of new technology, limiting its availability, and rationing access to specialists. A report in the ...